Blow: Medicaid expansion is just good business for Texas

You know the world is topsy-turvy when the Dallas Citizens Council comes out on the liberal side of a debate.

For that matter, you know these are strange days when the Citizens Council comes out publicly for anything at all. Though not the semi-secret cabal it once was, the high-powered organization still prefers to work behind the scenes.

But there, for everyone to see, was the recent guest column in this newspaper written by Citizens Council president Alice Murray. And of all things, it called for the expansion of Medicaid in Texas.

And in the current state of Texas politics, that’s akin to subletting the Alamo.

Now, I’m sure the venerable Citizens Council would prefer that its position be categorized as something other than liberal. A common-sense position, say. Or as enlightened conservatism.

And, yes, it strikes me as both of those things.

But Texas being Texas, and Dallas being Dallas, Murray’s guest column made clear how the Citizens Council sees the controversial Medicaid expansion. And that’s as good for bidness.

“An expansion of Medicaid is beneficial for business and a positive for our state’s future,” the column concluded. “We are hopeful other business groups will join us in a united front to tackle this issue.”

Hey, whatever works. I might have started with the humane and moral arguments first.

But if good-for-business gets the job done, so be it.

I talked to Murray last week about reaction to the column. “There has been a lot, which is what we hoped for,” she said. “We really want to spark a discussion about this.”

So was it a controversial topic within the ranks of the Citizens Council? “A little bit,” she said with a laugh that suggested more than a little bit.

But she said the issue was thoroughly studied and debated. Some members were specifically assigned to mount as strong a case against Medicaid expansion as possible.

In the end, it was an easy decision.

“It was a large majority that was in favor of the position we took,” she said.

And if it was mostly a business decision at the start, some of the mail Murray has been receiving certainly puts flesh and blood to the issue.

“I received one impassioned letter from a married mother of two. Without Medicaid expansion, she has no way to get insured. And now she has progressive multiple sclerosis. Oh, it’s such a sad story,” she said.

There is indeed a cruel twist to the current situation. The Affordable Care Act created insurance marketplaces and subsidized premiums for low-income Americans — but only for those above the poverty level.

Poorer families were supposed to be covered by this expansion of Medicaid. But when the U.S. Supreme Court ruled that states could opt out of the expansion, of course Texas did.

In Gov. Rick Perry’s Texas, it’s more important to try to make Obamacare fail than to extend health care coverage to an extra 1.5 million Texans through Medicaid.

So now we have this gap. The poorest of the poor qualify for health care assistance.

And those above the poverty level can get insurance through the Affordable Care Act marketplaces. But those earning just enough money to be at the poverty level are left out in the cold — people like the woman with MS who wrote to Murray.

Yes, there is a compelling case to be made for expanding Medicaid simply as the humane thing to do.

But if dollars make more sense to you, then the Dallas Citizens Council wants you to think about the difference that an extra $10 billion to $15 billion in federal funds could make for the state.

That’s the amount we will be giving up if the Texas Legislature doesn’t expand Medicaid for 2016 and 2017. Texas has already given up nearly $8 billion by rejecting Medicaid expansion for this year and next year.

Waco economist Ray Perryman has said “it is beyond question” that Texas should participate. And now the Dallas Citizens Council says so, too.